CDA/FHIR mapping implementations

Hi all

I am taking a pure implementer’s approach to build an intermediate representation (such as an XML) for mapping CDA<—>FHIR. I am using the smart-on-fhir as the reference implementation for this. The CDA I am trying to use is the Australian extension - ereferral (

Is it possible to create such an intermediate representation using the smart-on-fhir (or any other FHIR) reference implementation? Has anyone else tried this?

While searching for actual implementations I came across these repos:

The FHIR group has some hand crafted examples. Are there any equivalent CDA examples for these FHIR resources?

I have read some documents regarding the challenges between the transforms, such as:

  • David Hay’s blog:
  • Lantana Group position paper - “If or when FHIR can accommodate the full CDA use case, the future holds the promise of seamless integration and information sharing between clinical documents and APIs”. Does this mean that CDA<—>FHIR transform is not possible?

Intersystems presented its CDA shredder at the FHIR App meeting at Harvard this past summer. There is a presentation of it posted here.